Mark H. Meissner, MD, has been a vascular surgeon for 23 years and currently works at the University of Washington Medical Center and Medical School. He has particular clinical and research interest in deep venous thrombosis, chronic venous disease, vascular trauma, and abdominal aortic aneurysms. He received his medical degree from the University of Colorado and completed his surgical residency at the University of Washington. He’s been named one of America’s Leading Experts on Vascular Diseases and one of Castle Connolly’s Top Doctors. He has contributed to over 50 publications.
Why did you decide to become a doctor?
That’s a good question. I’ve pretty much known I wanted to become a doctor my whole life. Since I found out that you actually had to have talent to become a baseball player.
What are you presenting on at the VEITHsymposium?
I mostly talked about how the Affordable Care Act will change the way physicians make decisions and about physician reimbursement. I think the Affordable Care Act will have profound changes on physician reimbursement in the next five or six years.
What kind of changes do you think it will have?
Most of the recent changes in medical decision making have been based on a document that CMS (Centers for Medicare & Medicaid Services) published in 2008. It’s a roadmap to change the way we’re currently paid to more of a value-based system. Right now, physicians are paid on the basis of volume with little attention to either the quality of care or the cost of care. There’s going to start to be penalties for lower quality care in the next three or four years, and over time that’s going to be coupled with incentives to deliver lower cost care. It’s a three by three matrix with cost from low to high along one axis and quality from low to high along the other axis. You’re going to be paid the most for delivering very high-quality but low-cost care, and actually suffer penalties for delivering high-cost, low-quality care.
What kind of effect do you think this will have on patients?
Overall, I think it will have a positive effect on patients because insurance companies will be paying attention to the quality of care that’s delivered and the cost of that care, which I think benefits both patients as well as the health care system. It will also be a boost for physicians who deliver high-quality low-cost care. The only ones who will lose out are the physicians who deliver very high-cost, low-quality care.
How will this affect vascular patients specifically?
The initial measures are going to apply to physician groups or professional groups with more one hundred patients, and a lot of the physicians are primary care oriented. They’re taking care of things like hypertension, diabetes, and coronary artery disease. All vascular patients have those risk factors so it will impact them, but it will be more through their primary care doctors initially than through their vascular surgeons.
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